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Invasive coronary treatment strategies for out-of-hospital cardiac arrest: a consensus statement from the European Association for Percutaneous Cardiovascular Interventions (EAPCI/Stent for Life (SFL) groups

Noc, Marko; Fajadet, Jean; Lassen, Jens F.; Kala, Petr; MacCarthy, Philip; Olivecrona, Göran LU ; Windecker, Stephan and Spaulding, Christian (2014) In EuroIntervention 10(1). p.31-37
Abstract
Due to significant improvement in the pre-hospital treatment of patients with out-of-hospital cardiac arrest (OHCA), an increasing number of initially resuscitated patients are being admitted to hospitals. Because of the limited data available and lack of clear guideline recommendations, experts from the EAPCI and "Stent for Life" (SFL) groups reviewed existing literature and provided practical guidelines on selection of patients for immediate coronary angiography (CAG), PCI strategy, concomitant antiplatelet/anticoagulation treatment, haemodynamic support and use of therapeutic hypothermia. Conscious survivors of OHCA with suspected acute coronary syndrome (ACS) should be treated according to recommendations for ST-segment elevation... (More)
Due to significant improvement in the pre-hospital treatment of patients with out-of-hospital cardiac arrest (OHCA), an increasing number of initially resuscitated patients are being admitted to hospitals. Because of the limited data available and lack of clear guideline recommendations, experts from the EAPCI and "Stent for Life" (SFL) groups reviewed existing literature and provided practical guidelines on selection of patients for immediate coronary angiography (CAG), PCI strategy, concomitant antiplatelet/anticoagulation treatment, haemodynamic support and use of therapeutic hypothermia. Conscious survivors of OHCA with suspected acute coronary syndrome (ACS) should be treated according to recommendations for ST-segment elevation myocardial infarction (STEMI) and high-risk non-ST-segment elevation -ACS (NSTE-ACS) without OHCA and should undergo immediate (if STEMI) or rapid (less than two hours if NSTE-ACS) coronary invasive strategy. Comatose survivors of OHCA with ECG criteria for STEMI on the post-resuscitation ECG should be admitted directly to the catheterisation laboratory. For patients without STEMI ECG criteria, a short "emergency department or intensive care unit stop" is advised to exclude non-coronary causes. In the absence of an obvious non-coronary cause, CAG should be performed as soon as possible (less than two hours), in particular in haemodynamically unstable patients. Immediate PCI should be mainly directed towards the culprit lesion if identified. Interventional cardiologists should become an essential part of the "survival chain" for patients with OHCA. There is a need to centralise the care of patients with OHCA to experienced centres. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
cardiac arrest, coronary angiography, PCI
in
EuroIntervention
volume
10
issue
1
pages
31 - 37
publisher
Société Europa Edition
external identifiers
  • wos:000338980900009
  • scopus:84902346188
ISSN
1969-6213
DOI
10.4244/EIJV10I1A7
language
English
LU publication?
yes
id
019eddb4-744c-4b73-8bbd-079be2a8b9bb (old id 4598803)
date added to LUP
2014-09-05 12:06:39
date last changed
2017-11-12 03:04:19
@article{019eddb4-744c-4b73-8bbd-079be2a8b9bb,
  abstract     = {Due to significant improvement in the pre-hospital treatment of patients with out-of-hospital cardiac arrest (OHCA), an increasing number of initially resuscitated patients are being admitted to hospitals. Because of the limited data available and lack of clear guideline recommendations, experts from the EAPCI and "Stent for Life" (SFL) groups reviewed existing literature and provided practical guidelines on selection of patients for immediate coronary angiography (CAG), PCI strategy, concomitant antiplatelet/anticoagulation treatment, haemodynamic support and use of therapeutic hypothermia. Conscious survivors of OHCA with suspected acute coronary syndrome (ACS) should be treated according to recommendations for ST-segment elevation myocardial infarction (STEMI) and high-risk non-ST-segment elevation -ACS (NSTE-ACS) without OHCA and should undergo immediate (if STEMI) or rapid (less than two hours if NSTE-ACS) coronary invasive strategy. Comatose survivors of OHCA with ECG criteria for STEMI on the post-resuscitation ECG should be admitted directly to the catheterisation laboratory. For patients without STEMI ECG criteria, a short "emergency department or intensive care unit stop" is advised to exclude non-coronary causes. In the absence of an obvious non-coronary cause, CAG should be performed as soon as possible (less than two hours), in particular in haemodynamically unstable patients. Immediate PCI should be mainly directed towards the culprit lesion if identified. Interventional cardiologists should become an essential part of the "survival chain" for patients with OHCA. There is a need to centralise the care of patients with OHCA to experienced centres.},
  author       = {Noc, Marko and Fajadet, Jean and Lassen, Jens F. and Kala, Petr and MacCarthy, Philip and Olivecrona, Göran and Windecker, Stephan and Spaulding, Christian},
  issn         = {1969-6213},
  keyword      = {cardiac arrest,coronary angiography,PCI},
  language     = {eng},
  number       = {1},
  pages        = {31--37},
  publisher    = {Société Europa Edition},
  series       = {EuroIntervention},
  title        = {Invasive coronary treatment strategies for out-of-hospital cardiac arrest: a consensus statement from the European Association for Percutaneous Cardiovascular Interventions (EAPCI/Stent for Life (SFL) groups},
  url          = {http://dx.doi.org/10.4244/EIJV10I1A7},
  volume       = {10},
  year         = {2014},
}